Ticket for Outdoor Patient
| Ward No. 17 | U-PHC No. | Registration No. 00612 | Date 26/12/2019 |
| Token No | SM/19-20/1263 26/12/2019 | Serial | 003 |
| Patient Name | Mr. SAGAR NAYEK | Contact No | 8100049918 |
| Address | JITEN LAHIRI ROAD SERAMPORE 712201 | Age | 40 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||